Linking Research to Theory
Introduction
In the lives of most patients and their close ties today, suffering is not just due to the ailment alone but also due to the quality of the services obtained from the health systems as well. Some of the most common forms of poor patient services include the ratio of patients to each nurse due to shortage of qualified personnel, medical flaws and errors, portioned processes, and presence of health care providers characterized by uncaring relationships which cause doubts to the patients on the quality of services they receive, uncalled for financial burdens, needless stresses and discomforts, as well as dissatisfaction in the quality of health care services provided all of which result to poor care for the patients.
Some of the most common sources of prove for such misconducts among the health care personnel are patients’ discussions in hospitals waiting rooms, professional journals and newspaper articles, as well as in most end user magazines. Making matters worse, strict procedures are laid down in most health care institutions as of the time the family can spend time with their caring family members making the patients remain vulnerable to the uncaring conduct by the health care’s personnel. This time is often hastened and unfriendly and more often than not, the patient and their families are left wondering as of who will remain behind to care for their loved ones. This form of behavior is not solely to be blamed on the health care officials alone. On the contrary, the drastic shift to paying attention to costs, technology, and activities from the emphasis on diagnostic testing, medications, and procedures by the health practice has contributed to a large extent.
As a result, there has been a creation of a gap between the professional values and conduct of the health care professionals may, to a large extent, be said to have resulted to the poor outcomes in the health care institutions. One major concern for such incongruity is the visible reduction in time spent to nature the already existing relationship between the patients, their families and the health care institution. With such an environment, nurses may be making vulnerable their professional uprightness which result to lack of motivation. Particularly, the most affected group of health professionals is nurses who form the majority of the staff. The purpose of this paper is to prove whether caring relationships with nurses produce better patient outcomes.
Background information of the problem
As is observable for most health care institutions, nursing ethics that come with the theoretical foundations of nursing are most of the time neglected and this results to the poor quality of services provided to patients in the most health institutions. In addition, the number of patients allocated each nurse at any given time in the health institution is also a contributing factor on the quality of the health care services provided to a patient at any given moment.
It has been observed that, the number of patients allocated to a given nurse at any given moment determines the level of relationship that may exist between the patient and the nurse. The higher this number goes, the poor the relationship as the nurse has to plan their time to satisfy all the patients under their care and this means that the time slot for a given patient also reduces. In addition, if the number of patients against a given nurse is too much, there is a tendency by the nurse to forfeit some of the patients only leaving attention to patients they feel are more urgent and more in need that all the others.
Taking the case of an ICU where all the patients are in dire need of a health care professional to keep a close eye on them, increasing the number of patients and while maintaining single nurse for all the patients means that the patients will be ranked from the one the nurse feels requires much attention to the ones that require least attention. For such a case, the nurse tends to get tired so easily and ends up not attending all the patients as is required of them by the nursing ethics and practices.
According to research, there have been reported instances where patents have performed poorly in their recovery from ailments. According to Dutty (2009), among the many factors contributing to such results, the main factor is poor relationships between patients and the health officials undersigned to take care of them. For instance, institutions with health officials of poor integrity have patients portraying a negative image for them everywhere even in the health centers’ waiting rooms.
Statement of the problem
According to Duffy (2009), the research has showed that the deteriorated health care services by the professionals is one among the key factors that contribute to the poor outcomes in patients in hospitals. The main concern for this paper is the association between the level of satisfaction from the intensive care unit (ICU) and a step down unit where the ratio is 1:3 in the ICU as compared to the ratio in the step down unit which is 1:6. Practically, the number of patients in the ICU is less than that of patients in the step down yet each of them is under the care of one health official. As is truly observable, the patients in the step down unit are likely to experience poor health care services as compared to those in the ICU. On the contrary, the patients in the ICU may receive poor health service if the nurse they are under the care of has lost the nursing ethics and hence risking their integrity.
The purpose of this study is to therefore link the findings of research provided from the ICU and the step down unit to the theory about the same (Friedman, Bowden and Jones 2003). Such a link will serve the purpose of explaining whether or not the caring relationships with nurses produce better patient outcome for ICU and step down units.
Research question
From the problem statement above, one can then require to know, how the nurse to patient ratio affects the quality of patient’s outcome in an ICU as compared to a Step down unit in a health unit.
One theory to use to bring out a clear picture of this hypothesis is the one that states that the ratio of nurse to patient in the ICU is 1:3 while that of the step down unit is one is to six. Ordinarily, the patients in the ICU are in fast need of attention and for that matter, the presence of a health attendant is of great importance (Isaacs, Colby 2007). The patients in a step down unit are in need of attendance just for some time maybe while taking medications and during inspections and progress examinations. For this reasons the ratios of the healthcare officials to patients are different.
Participants
In this study, the participants are two health officials and nine patients.
Patients
This is the group that will participate in the study and will be split into two groups. The first group will contain three patients who will be in very critical conditions and so will be in the ICU. The second group of patients will be made up of six members who will participate in the Step down unit of the health centre.
Nurses
This is the group that will deal with caring for the patients.
Methodology
The study will take place in two ways; first, the nurses will each care for all the nine patients each at their own time and then each with a given group of patients.
Working in shifts
To begin with, the each nurse is given the responsibility of caring for all the six patients in different wards and in different health conditions. The patients remain in their rooms and each nurse works for eight consecutive hours before leaving duty to the other patient. On another day, the nurses are each assigned duties in different department and each still works for an average of eight hours.
Findings
It is found that, the while all the patients were under the care of a single nurse, there is poor attention of the patients by the nurse especially those in the Intensive Care Unit. This poor attention weakens the patients relationships with the nurse and this may result to poor recovery as on the part of the patient. This is so severe that it may cause deaths of patients in overly critical conditions.
On the other hand, the nurse feels overworked and just ends up getting tired so fast that they rarely give full attention to the patients as is required. At this point in time, the work covered by the patient is full of errors and the patient may end up receiving wrong diagnosis due to the low level of concentration by the nurses (Perrin and McGhee 2001). Furthermore, the nurse may end up being discouraged by the overload and decide to sacrifice his or her integrity at the expense of fulfilling his or her duty which is quit risky as the nurse may end up providing poor quality of services to patients who will end up gaining doubts about the level of integrity in the medical attention provided to them.
In addition, due to the shift of attention of health care to technology and cost from diagnosis, there are increased chances of forfeiting the sick in order to fulfill these secondary calls and as a result, the patients’ live remains at stake of being lost or make it to recovery zones. On the other hand, when patients in each group are kept under the care of a separate health personnel, the recovery process is made easy as the patients are each provided with at least a more intense attention by and their needs are met to a greater fulfillment than when one nurse attends the entire patient at a go.
In addition, the nurses are found to work for longer hours before wearing off and this means the quality and level of attention is with minimum errors as compared to when one nurse cares for all the nine patients at the same time. It is true to say that, if a third experiment was made and this time round the number of patients in the ICU and those in the Step down unit each at a time were attended by the two attendants together, the relationship between nurses and patients would be the strongest.
As a result, the patients would be made show even better patient recovery outcomes (Nelson 1997). This would be the best way to handle the patients’ ailments as the nurses are less likely to grow tired and their effectiveness is high as they can work in turns reducing chances of getting weary and the chances of making errors.
Discussion
From the experiment, the stronger the relationship between the patients and the nurses, the higher the chances of recovering as the nurse, for instance doesn’t grow weary and so remains effective in the quality of patient services they offer and this minimizes the chances of errors that may result due to fatigue by a great percentage (Isaacs and Colby 2007). This is the case when both nurses are wording at the same time and in the same department. The main drawback for this method is that a section of the patients end up without attendance at one given time. This has the worst effects and is not recommended.
As of the second experiment, the relationship between the patient and the nurses is also strong and there is attendance to the patients at any given moment in each department. This reduces the chances of the patients receiving erroneous diagnosis or the nurses getting weary fast as compared to when the ratio of the patients to the nurse is one is to nine. In addition all the departments have attendance at the same time and these results to an all round patient attendance, that is, there is no group that is forfeited at for another. This is the best way to resolve the problem or recovery of patients.
As of the first experiment, the level of fatigue on the part of the nurse is very high and this compromises both the quality of diagnosis or treatment and the integrity of the health official. As compared to the other two methods, this is the method in which the nurses are more fatigued and is characterized by errors in diagnosis, compromised patient treatment and nurse’s integrity. Such fatigue can also be associated with loss of lives as the nurse cant be at different places at the same time (Marshall and Coughlin 2010).
From the paper, the having each nurse serve their own department is useful as it enables the patients have ample time to be at the disposal of a health official at the same time. This means that no group is attended at the expense of the other. In addition, the chances of the nurse being fatigued are lower and so the nurses can hence remain effective for the period of time allocated for their shifts. As of the third experiment, the only way to improve it is to ensure that there are two more attendants to reduce the chances of there being a chance of foregoing the interests of some patients.
References
Duffy J. (2007). Quality Caring in Nursing.New York: NY.
Friedman M Bowden V. and Jones E (2003). Family Nursing: Research, Theory and Practice.Prentice Hall. United States: USA.
Isaacs L. and Colby D. (2007). To Improve Health and Health Care. Wood Johnson Foundation. New Jersey: USA.
Marshall E. and Coughlin J. (2010). Transformational Leadership in Nursing. Springer Publishing. New York: NY.
Nelson R. (2003). Ethics in the Intensive Care Unit. Elsevier. New York: NY.
Perrin O. and McGhee (2001). Ethic and conflict. Slack Incorporated. United States of America: USA.
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